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The Rose and the Nightingale: The role of poetry in Persian culture By Dr. Hossein Elahi Ghomshei

The Relevance of the UN in Its 60th Year By Shashi Tharoor

The Nuclear Taboo Interview with Nina Tannenwald

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Women's Health: Key to a Better World

The following article is adapted from a speech by World Health Organization (WHO) Director General Gro Harlem Brundtland on the occasion of the five-year review of the Beijing “Platform for Action.”

Over the past half-century, the world has made some great achievements. Overall, people live longer. They live better. They have more choices than before, both in their private lives and in the societies they are part of. There is great reason to celebrate these achievements.

Yet there is still a long way to go before we can say that the successes of the past 50 years are shared by everyone all over the world. And there is still a long way to go before we can say that men and women have shared those successes equally.

The UN international conferences, such as the Fourth World Congress on Women held in Beijing five years ago, have highlighted the key role of women in ensuring sustainable development. No doubt much of the impetus for this came from the international women's movement which may be the largest social movement in human history.

The five years which have passed since the meeting in Beijing seem like such a long time. The world has been through so much in those years: the internet revolution and the emergence of the "new economy"; growing globalization as a world-shaping force; the economic crises and rebound of Asian and Latin American economies; local wars and sporadic armed conflict in many parts of the world.

But while the situation for women made leaps of progress between 1960 and 1995, we have not seen much progress over these past five years. There have been improvements, that is true. But so often, the positive developments in one area have been canceled by setbacks in others.

I was in Beijing five years ago, and I was encouraged by the unity and determination for change I sensed among the many thousands of women there. At the time I noted, though, that there still was not a single country or institution in the world where men and women enjoy equal opportunities. Has that changed over the past five years? I am afraid not.

This doesn't mean there is any reason to be pessimistic--only to be impatient. Fundamental, global changes can happen quickly--if the conditions are right. Achieving equality for women and full respect for their rights involves large and complex issues, but that doesn't mean it should take decades to achieve progress.

Call for Change

Five years ago I said that changes must take place in the boardrooms as well as in the shantytowns. I said they must take place from the suburbia of Europe and North America to the poor farmlands in Africa and everywhere in between.

I would say the same today. But I would add that our main priority should be to eradicate poverty and discrimination against women which the 20th century has shown to be crippling, debilitating and choice-limiting forces. Furthermore, we have learned that, although poverty and discrimination burden the lives of both women and men, there is little doubt that by most measures and in most places women are more often and more seriously affected.

Poverty has a woman's face. More than 70 percent of the poorest 1.3 billion people of the world are women. Of the 900 million illiterate people, women outnumber men, two to one.

Gender-based discrimination combined with poverty prevents women from leaving situations of abuse and exploitation. They interact to allow small power elites to maintain damaging and discriminatory practices under the guise of cultural or religious tradition. Poverty leads to ill health, which puts additional strain on already overstretched households. And when women fall ill, gender-based discrimination may limit their access to dignified, technically appropriate care and treatment.

The fight against poverty and discrimination must be our global cause as we straddle the millennium. Our goal must be to create a world where all can live with dignity. And we must do this without undermining future generations' ability to continue to do the same. Only then will women have a chance to achieve a life of respect, quality and equality, and this will be good for men as well.

Further, I would argue that societies will only be able to prosper and emerge from poverty if their women enjoy better health. Health must, therefore, be at the heart of our struggle for equality and sustainable development.

Why health? one may ask. Because health is a fundamental prerequisite for a good life and the ability to support oneself, as well as for the enjoyment of other human rights.

The health of women matters--foremost to women themselves. But it also matters to their families, communities and societies. Indeed, the health of women is a fundamental pillar that underpins sustainable human development.

Of course, we cannot consider the health of women in isolation. Men--fathers, brothers, husbands, sons--are important. Women live in complex social contexts, and gender roles and relations are embedded within that context. In order to improve the health of women, we have to analyze the determinants of women's health status within the reality of their lives. This is why I am committed to incorporating a gender perspective in health across WHO's work.

What is a gender perspective and why is it important? A gender perspective focuses on the roles and relations between men and women. It is also important to remember that gender not only refers to the relations between the sexes at the individual, personal level. It also takes into account the values and norms that permeate societies, institutions and organizational systems, including the health and legal systems.

Safe Motherhood

Although the health needs of women are more than their reproductive health, in the developing countries where most women live, their health is strongly influenced by their role as mothers. If we value this role, how can we fail to provide them with the means for safe motherhood? Over half a million women die in childbirth each year, and 20 million suffer childbirth-related illnesses or other health problems. Yet this suffering could be avoided if all women had the assistance of a skilled healthcare worker during delivery. Is it so difficult to provide this simple assistance to all women?

If we are serious about women's health, we must give them the means and right to defend themselves against HIV/AIDS. In 1980, 20 percent of the adults infected with HIV were women. By 1992 that figure had risen to 42 percent. By the end of 1999, 46 percent of HIV-positive adults were women. In some parts of Africa infection rates of adolescent girls now run from three to six times higher than boys of the same age.

Improving health also means challenging and ending all forms of violence against women, including female genital mutilation, trafficking of women, domestic violence, rape and sexual abuse. It means changing the social norms that accept, condone and perpetuate violence against women in all societies.

We cannot talk about improving women's health without ending the abuse of health technology and expertise for what is obscurely termed "prenatal sex selection" and which in practice means aborting or killing infant girls due to cultural beliefs about their low worth.

We must also make sure that women get equal attention and care in health systems.

We cannot overcome poverty and gender discrimination if we do not take the health of the world's women more seriously. We need to take a comprehensive look at the health of women throughout their lives and take up the challenge of new issues not brought to global attention before. The mental health of women is a relatively new field of concern, but evidence makes it clear it is important. We all need to think carefully about our own societies and how our own ways of living may harm the health of girls and women. Depression, for example, affects women twice as often as men. Some of this may be due to biological factors. But women's lack of control over their lives can be an important factor.

What about education? Access to education for girls, as well as the type of education they receive, is also often affected by gender norms. Despite undeniable proof that educating women is one of the most important health and development investments a country can make, girls are still prevented from completing even primary education in many countries.

Further up the scale of economic development, gender biases affect women's choice of studies, and there is still a tendency in many countries to encourage boys toward careers in sciences and mathematics, and girls toward careers in the sectors associated with caring, such as teaching and nursing. This limits choice and limits the expression of human resources, both in men and women. But first of all, it is to the disadvantage of girls and women in our societies.

Fortunately, we have seen a marked increase in the number of women who become doctors in many countries around the globe. This is important not only because many women prefer dealing with a woman doctor and, in some countries, are required to only see women doctors. It is also significant because women doctors can bring a better understanding of women's problems and special needs into the hospitals and health ministries. This can over time influence decision-making in a way that favors women and children.

Barriers Still in Place

Even at the top, women face barriers all over the world. At this level, they are often more subtle and difficult to see. I am referring to the "glass ceiling" on the corporate ladder, to try to illustrate why only two out of the world's 500 largest companies are headed by a woman. Stereotypes and misconceptions which work against women are often made worse by practical difficulties, like inadequate child care and maternity leave.

In my country, Norway, we have had the experience that policy change really helps. From 1986, with a new era in politics, and a woman-friendly, child-friendly, family-friendly political reform agenda, more women entered the labor market; more children had an opportunity to have a place in a kindergarten and enjoy play and education with their peers; more men spent more time with their children and took paternity leave for at least four weeks. Mothers could stay home with 80-percent pay for a whole year after birth, or choose to work half-time for a full two years. And a new era and spirit of optimism helped reverse the decades-long trend of women choosing to have fewer children. Now, birthrates have increased in a more family-friendly society.

I have said investing in health makes good economic sense. I will also add that investing in women makes even better economic sense. Overlooking women's contribution to the economy has had severely damaging effects. Often women cannot even obtain a modest loan to become more independent and productive. In many countries, women own nothing, they inherit nothing and have no security.

But beyond the economic sense, investing in women is the right thing to do. Women will become empowered only through change in legislation, increased information and by redirecting resources. We did not fully succeed in doing that in the 20th century. If we are to do better in the 21st century, we need stronger political commitment, new resources and new alliances.

We need to recognize that women must be involved in the events and processes that shape their lives. A world where men and women share more equally in political and economic decision-making would be a world where health and social welfare are given greater weight and where education for all is paramount.

We must learn from, and draw upon, the myriad of initiatives that women are undertaking worldwide to overcome economic hardship and gain recognition of their rights. We must insist on making public a discussion of the universal values and dreams that influence the ultimate direction of our societies.

Things do not happen by chance. It takes committed people and farsighted leaders to push at the closed doors and to ask why things should not change. There is ample evidence now to show that all of our lives and futures will be better if men and women have the opportunity to play an equal part in society.

Every second a baby boy and baby girl are born into this world. They all deserve love and care, a future and opportunities. There is nothing so thoroughly, so unconditionally trusting as the look in the eyes of a newborn girl or boy child. From that privilege we must set out to make ourselves worthy of the look in those eyes.

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